How Disease Decimated Black Soldiers in the Civil War


Black and white civil war soldiers with weapons in a line looking at camera

By the late summer of 1864, a century and a half ago, more than 100,000 African American soldiers were serving in the U.S. Civil War, providing a much-needed boost to Abraham Lincoln’s struggling Union forces. These proud soldiers, many of whom were former slaves, “had been to the armory of God,” said one black sergeant, “and had received weapons of the heart, that made them daring and dangerous foes.”

The Union’s newest enlistees fought courageously, but neither God nor their new employer had equipped them with the armor to fight an even more daunting enemy than the Confederacy: Disease.

According to The Library of Congress, an astonishing 29,000 of those 100,000 black soldiers died from disease during the Civil War. Or, nine times the number that would perish fighting.

Pneumonia, malaria, dysentery, small pox and typhoid fever were the primary culprits, and devastated many black units: One black infantry regiment lost 524 soldiers to disease in a single year, half of its overall numbers. As one lieutenant stationed in Louisiana wrote: “The mortality in our Regt. beats anything that I ever saw. They frequently drop dead in the streets.”

The Civil War was the greatest biological crisis of the 19th century. Unsanitary camps, unburied bodies and inadequate medical care contributed to the deaths of over 400,000 soldiers from disease. According to historian Glenn W. LaFantasie, author of Gettysburg Requiem (2006), “[d]isease and primitive medical knowledge were the Civil War soldier’s worst enemies. For every soldier killed in battle, two died of disease.”

A white doctor observed, ‘[V]ery few surgeons will do precisely for blacks as they would for whites.’

The camp conditions confronting the average soldier were appalling. For black soldiers, it was even worse. Those who became ill “died at a rate two and a half times higher than their white counterparts,” according to The Library of Congress.

Discrimination led not only to unequal pay and poorly-provisioned regiments, but grossly deficient medical care. Many white medical officers were unwilling to treat black units, one white doctor observing that “[v]ery few surgeons will do precisely for blacks as they would for whites.” And there were only three black physicians serving the Union Army’s 166 black regiments.

Emancipation and the long war caused severe dislocation in black communities, disrupting kin networks, and leaving millions without adequate shelter, food or access to medical care. And things would only get worse: Sickness and disease threatened the lives of 3.5 million freed slaves after the war ended.

Prior to the Civil War, the great orator, journalist and abolitionist, Frederick Douglass, had argued, “let the black man get upon his person the brass letters, U.S.; let him get an eagle on his button, and a musket on his shoulder, and bullets in his pocket, and there is no power on earth which can deny that he has earned the right to citizenship.” 

By the time the 14th Amendment finally granted citizenship to freed slaves in 1868, the combination of disease, war, discrimination and unthinkable hardship had taken a massive toll on black soldiers and communities, but there was, as Douglass had predicted, no question that they had not just earned citizenship but also deserved the eternal respect and admiration of a nation.

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